Journal of therapeutic ultrasound最新文献

{"title":"Multiscale Modeling of transcranial focused ultrasoundneurostimulation and experimental validation: initial results","authors":"Hazael Montanaro, Mehmet Ozdas, E. Neufeld, Théo Lemaire, S. Micera, M. Yanik, N. Kuster","doi":"10.3929/ETHZ-B-000321144","DOIUrl":"https://doi.org/10.3929/ETHZ-B-000321144","url":null,"abstract":"","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 1","pages":"77-78"},"PeriodicalIF":0.0,"publicationDate":"2018-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42120630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental study of beam distortion due to fiducial markers during salvage HIFU in the prostate.","authors":"Marina Bakaric,&nbsp;Eleanor Martin,&nbsp;Panayiotis S Georgiou,&nbsp;Benjamin T Cox,&nbsp;Heather Payne,&nbsp;Bradley E Treeby","doi":"10.1186/s40349-018-0109-3","DOIUrl":"https://doi.org/10.1186/s40349-018-0109-3","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is frequently treated using external beam radiation therapy (EBRT). Prior to therapy, the prostate is commonly implanted with a small number of permanent fiducial markers used to monitor the position of the prostate during therapy. In the case of local cancer recurrence, high-intensity focused ultrasound (HIFU) provides a non-invasive salvage treatment option. However, the impact of the fiducial markers on HIFU treatment has not been thoroughly studied to date. The objective of this study was to experimentally investigate the effect of a single EBRT fiducial marker on the efficacy of HIFU treatment delivery using a tissue-mimicking material (TMM).</p><p><strong>Methods: </strong>A TMM with the acoustic properties of the prostate was developed based on a polyacrylamide hydrogel containing bovine serum albumin. Each phantom was implanted with a cylindrical fiducial marker and then sonicated using a 3.3 MHz focused bowl HIFU transducer. Two sets of experiments were performed. In the first, a single lesion was created at different positions along either the anteroposterior or left-right axes relative to the marker. In the second, a larger ablation volume was created by raster scanning. The size and position of the ablated volume were assessed using a millimetre grid overlaid on the phantom.</p><p><strong>Results: </strong>The impact of the marker on the position and size of the HIFU lesion was significant when the transducer focus was positioned within 7 mm anteriorly, 18 mm posteriorly or within 3 mm laterally of the marker. Beyond this, the generated lesion was not affected. When the focus was anterior to the marker, the lesion increased in size due to reflections. When the focus was posterior, the lesion decreased in size or was not present due to shadowing.</p><p><strong>Conclusions: </strong>The presence of an EBRT fiducial marker may result in an undertreated region beyond the marker due to reduced energy arriving at the focus, and an overtreated region in front of the marker due to reflections. Depending on the position of the targeted regions and the distribution of the markers, both effects may be undesirable and reduce treatment efficacy. Further work is necessary to investigate whether these results indicate the necessity to reconsider patient selection and treatment planning for prostate salvage HIFU after failed EBRT.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"6 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2018-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-018-0109-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35956467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcium-dependent ultrasound stimulation of secretory events from pancreatic beta cells.","authors":"Ivan Suarez Castellanos, Tania Singh, Bogdan Balteanu, Diti Chatterjee Bhowmick, Aleksandar Jeremic, Vesna Zderic","doi":"10.1186/s40349-017-0108-9","DOIUrl":"10.1186/s40349-017-0108-9","url":null,"abstract":"<p><strong>Background: </strong>Our previous studies have indicated that ultrasound can stimulate the release of insulin from pancreatic beta cells, providing a potential novel treatment for type 2 diabetes. The purpose of this study was to explore the temporal dynamics and Ca²⁺-dependency of ultrasound-stimulated secretory events from dopamine-loaded pancreatic beta cells in an in vitro setup.</p><p><strong>Methods: </strong>Carbon fiber amperometry was used to detect secretion from INS-1832/13 beta cells in real time. The levels of released insulin were also measured in response to ultrasound treatment using insulin-specific ELISA kit. Beta cells were exposed to continuous wave 800 kHz ultrasound at intensities of 0.1 W/cm², 0.5 W/cm² and 1 W/cm² for several seconds. Cell viability tests were done with trypan blue dye exclusion test and MTT analysis.</p><p><strong>Results: </strong>Carbon fiber amperometry experiments showed that application of 800 kHz ultrasound at intensities of 0.5 and 1 W/cm² was capable of stimulating secretory events for durations lasting as long as the duration of the stimulus. Furthermore, the amplitude of the detected peaks was reduced by 64% (<i>p</i> < 0.01) when extracellular Ca²⁺ was chelated with 10 mM EGTA in cells exposed to ultrasound intensity of 0.5 W/cm². Measurements of released insulin in response to ultrasound stimulation showed complete inhibition of insulin secretion by chelating extracellular Ca²⁺ with 10 mM EGTA (<i>p</i> < 0.01). Viability studies showed that 800 kHz, 0.5 W/cm² ultrasound did not cause any significant effects on viability and metabolic activity in cells exposed to ultrasound as compared to sham-treated cells.</p><p><strong>Conclusions: </strong>Our results demonstrated that application of ultrasound was capable of stimulating the release of insulin from pancreatic beta cells in a safe, controlled and Ca²⁺-dependent manner.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2017-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35319179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple ultrasound cavitation-enabled treatments for myocardial reduction.","authors":"Douglas L Miller,&nbsp;Xiaofang Lu,&nbsp;Chunyan Dou,&nbsp;Yiying I Zhu,&nbsp;Mario L Fabiilli,&nbsp;Gabe E Owens,&nbsp;Oliver D Kripfgans","doi":"10.1186/s40349-017-0107-x","DOIUrl":"https://doi.org/10.1186/s40349-017-0107-x","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound myocardial cavitation enabled treatment (MCET) is an image-guided method for tissue reduction. In this study, a strategy of fractionated (multiple) treatments was tested for efficacy.</p><p><strong>Methods: </strong>Dahl SS rats were anesthetized and prepared for treatment with a focused ultrasound transducer in a warm water bath. Aiming at the anterior left ventricular wall was facilitated by imaging with a 10 MHz phased array (10S, GE Vivid 7, GE Vingmed Ultrasound, Horten, Norway). MCET was accomplished at 1.5 MHz by pulse bursts of 4 MPa peak rarefactional pressure amplitude, which were intermittently triggered 1:8 from the ECG during infusion of a microbubble suspension for cavitation nucleation. Test groups were sham, a 200 s treatment, three 200 s treatments a week apart, and a 600 s treatment. Treatment outcome was observed by plasma troponin after 4 h, echocardiographic monitoring and histology at 6 wk.</p><p><strong>Results: </strong>The impacts of the fractionated treatments summed to approximately the same as the long treatment; e. g. the troponin result was 10.5 ± 3.2 for 200 s, 22.7 ± 5.4 (<i>p</i> < 0.001) for the summed fractionated treatments and 29.9 ± 6.4 for 600 s (<i>p</i> = 0.06 relative to the summed fractionated). While wall thickness was not reduced for the fractionated treatment, tissue strain was reduced by 35% in the target area relative sham (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The ability to fractionate treatment may be advantageous for optimizing patient outcome relative to all-or nothing therapy by surgical myectomy or alcohol ablation.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"29"},"PeriodicalIF":0.0,"publicationDate":"2017-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-017-0107-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35260479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical trial protocol for TARDOX: a phase I study to investigate the feasibility of targeted release of lyso-thermosensitive liposomal doxorubicin (ThermoDox®) using focused ultrasound in patients with liver tumours.","authors":"Paul C Lyon, Lucy F Griffiths, Jenni Lee, Daniel Chung, Robert Carlisle, Feng Wu, Mark R Middleton, Fergus V Gleeson, Constantin C Coussios","doi":"10.1186/s40349-017-0104-0","DOIUrl":"10.1186/s40349-017-0104-0","url":null,"abstract":"<p><strong>Background: </strong>TARDOX is a Phase I single center study of ultrasound triggered targeted drug delivery in adult oncology patients with incurable liver tumours. This proof of concept study is designed to demonstrate the safety and feasibility of targeted drug release and enhanced delivery of doxorubicin from thermally sensitive liposomes (ThermoDox®) triggered by mild hyperthermia induced by focused ultrasound in liver tumours. A key feature of the study is the direct quantification of the doxorubicin concentration before and after ultrasound exposure from tumour biopsies, using high performance liquid chromatography (HPLC).</p><p><strong>Methods/design: </strong>The study is conducted in two parts: Part 1 includes minimally-invasive thermometry via a thermistor or thermocouple implanted through the biopsy co-axial needle core, to confirm ultrasound-mediated hyperthermia, whilst Part 2 is carried out without invasive thermometry, to more closely mimic the ultimately intended clinical implementation of the technique. Whilst under a general anaesthetic, adult patients with incurable confirmed hepatic primary or secondary (metastatic) tumours receive a single cycle of ThermoDox®, immediately followed by ultrasound-mediated hyperthermia in a single target liver tumour. For each patient in Part 1, the HPLC-derived total doxorubicin concentration in the ultrasound-treated tumour is directly compared to the concentration before ultrasound exposure in that same tumour. For each patient in Part 2, as the tumour biopsy taken before ultrasound exposure is not available, the mean of those Part 1 tumour concentrations is used as the comparator. Success of the study requires at least a two-fold increase in the total intratumoural doxorubicin concentration, or final concentrations over 10 μg/g, in at least 50% of all patients receiving the drug, where tissue samples are evaluable by HPLC. Secondary outcome measures evaluate safety and feasibility of the intervention. Radiological response in the target tumour and control liver tumours are analysed as a tertiary outcome measure, in addition to plasma pharmacokinetics, fluorescence microscopy and immunohistochemistry of the biopsy samples.</p><p><strong>Discussion: </strong>If this early phase study can demonstrate that ultrasound-mediated hyperthermia can effectively enhance the delivery and penetration of chemotherapy agents intratumorally, it could enable application of the technique to enhance therapeutic outcomes across a broad range of drug classes to treat solid tumours.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02181075, Edura-CT Identifier: 2014-000514-61.Ethics Number: 14/NE/0124.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"28"},"PeriodicalIF":0.0,"publicationDate":"2017-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35536886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A framework for continuous target tracking during MR-guided high intensity focused ultrasound thermal ablations in the abdomen.","authors":"Cornel Zachiu,&nbsp;Baudouin Denis de Senneville,&nbsp;Ivan D Dmitriev,&nbsp;Chrit T W Moonen,&nbsp;Mario Ries","doi":"10.1186/s40349-017-0106-y","DOIUrl":"https://doi.org/10.1186/s40349-017-0106-y","url":null,"abstract":"<p><strong>Background: </strong>During lengthy magnetic resonance-guided high intensity focused ultrasound (MRg-HIFU) thermal ablations in abdominal organs, the therapeutic work-flow is frequently hampered by various types of physiological motion occurring at different time-scales. If left un-addressed this can lead to an incomplete therapy and/or to tissue damage of organs-at-risk. While previous studies focus on correction schemes for displacements occurring at a particular time-scale within the work-flow of an MRg-HIFU therapy, in the current work we propose a motion correction strategy encompassing the entire work-flow.</p><p><strong>Methods: </strong>The proposed motion compensation framework consists of several linked components, each being adapted to motion occurring at a particular time-scale. While respiration was addressed through a fast correction scheme, long term organ drifts were compensated using a strategy operating on time-scales of several minutes. The framework relies on a periodic examination of the treated area via MR scans which are then registered to a reference scan acquired at the beginning of the therapy. The resulting displacements were used for both on-the-fly re-optimization of the interventional plan and to ensure the spatial fidelity between the different steps of the therapeutic work-flow. The approach was validated in three complementary studies: an experiment conducted on a phantom undergoing a known motion pattern, a study performed on the abdomen of 10 healthy volunteers and during 3 in-vivo MRg-HIFU ablations on porcine liver.</p><p><strong>Results: </strong>Results have shown that, during lengthy MRg-HIFU thermal therapies, the human liver and kidney can manifest displacements that exceed acceptable therapeutic margins. Also, it was demonstrated that the proposed framework is capable of providing motion estimates with sub-voxel precision and accuracy. Finally, the 3 successful animal studies demonstrate the compatibility of the proposed approach with the work-flow of an MRg-HIFU intervention under clinical conditions.</p><p><strong>Conclusions: </strong>In the current study we proposed an image-based motion compensation framework dedicated to MRg-HIFU thermal ablations in the abdomen, providing the possibility to re-optimize the therapy plan on-the-fly with the patient on the interventional table. Moreover, we have demonstrated that even under clinical conditions, the proposed approach is fully capable of continuously ensuring the spatial fidelity between the different phases of the therapeutic work-flow.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2017-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-017-0106-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35460512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current and emerging brain applications of MR-guided focused ultrasound.","authors":"Ying Meng,&nbsp;Suganth Suppiah,&nbsp;Karim Mithani,&nbsp;Benjamin Solomon,&nbsp;Michael L Schwartz,&nbsp;Nir Lipsman","doi":"10.1186/s40349-017-0105-z","DOIUrl":"https://doi.org/10.1186/s40349-017-0105-z","url":null,"abstract":"<p><p>MRI guided focused ultrasound is an emerging technique that uses acoustic energy to noninvasively treat intracranial disorders. At high frequencies, it can be used to raise tissue temperatures and ablate discrete brain targets with sub-millimeter accuracy. This application is currently under investigation for a broad range of clinical applications, including brain tumors, movement disorders, and psychiatric conditions. At low frequencies MRI guided focused ultrasound can be used to modulate neuronal activity and in conjunction with injected microbubbles, can open the blood-brain barrier to enhance the delivery of therapeutic compounds. The last decade has seen dramatic advances in the science of MRI guided focused ultrasound, helping elucidate both its mechanisms and potential in pre-clinical models, and its translational promise across myriad clinical applications. This review provides an update of current and emerging MRI guided focused ultrasound applications for intracranial disorders and describes future directions and challenges for the field.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"26"},"PeriodicalIF":0.0,"publicationDate":"2017-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-017-0105-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35452531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic Resonance-guided High Intensity Focused Ultrasound in the presence of biopsy markers.","authors":"Charles Mougenot,&nbsp;Chrit Moonen","doi":"10.1186/s40349-017-0103-1","DOIUrl":"https://doi.org/10.1186/s40349-017-0103-1","url":null,"abstract":"<p><strong>Background: </strong>Magnetic Resonance guided High Intensity Focused ultrasound (MR-HIFU) offers precise non-invasive thermotherapy for clinical applications such as the treatment of breast lesions. However, patients with a biopsy marker are usually not eligible for MR-HIFU treatment. This study investigates the interaction of some MR-compatible markers with MR-HIFU thermotherapy.</p><p><strong>Methods: </strong>The MR-HIFU compatibility of 14 markers (6 Gold Anchor and 4 Visicoil markers in gold, 1 Visicoil marker in brass, 3 BiomarC markers in carbon coated) were tested using the Sonalleve breast MR-HIFU platform at 1.5 T. The impact of these markers was assessed by counting the number of voxels with low signal intensity on MR thermal maps and by comparing temperature increases induced by the HIFU beam.</p><p><strong>Results: </strong>Most markers were visible on thermal maps with an apparent size 4.2 ± 3.1 and 2 ± 1.8 times larger than their respective actual width and length. The volume of masked voxels was for most of the markers much larger than the actual volume of the marker (up to a factor 65.1). However, it represents only a small fraction of the 12 mm diameter targeted region (up to 8.8 voxels which represents 19% of this targeted region). Some differences in the maximal temperature increase were observed especially for BiomarC 1 × 3 and BiomarC 2 × 4 markers enhancing the heating. These differences were less pronounced at the edge of the targeted region.</p><p><strong>Conclusion: </strong>All markers had a minimal impact on the volume above the thermal dose threshold of 240 EM since the differences measured were smaller than the in-plane image resolution of 1.56 mm.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-017-0103-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35439748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of real-time tissue change monitoring during prostate tissue ablation with high intensity focused ultrasound.","authors":"Narendra T Sanghvi, Wo-Hsing Chen, Roy Carlson, Clint Weis, Ralf Seip, Toyoaki Uchida, Michael Marberger","doi":"10.1186/s40349-017-0102-2","DOIUrl":"10.1186/s40349-017-0102-2","url":null,"abstract":"<p><strong>Background: </strong>The purpose of these clinical studies was to validate a Tissue Change Monitoring (TCM) algorithm in vivo. TCM is a quantitative tool for the real-time assessment of HIFU dose. TCM provides quantitative analysis of the backscatter pulse echo signals (pre and immediately post HIFU) for each individual ablative site, using ultrasonic tissue characterization as a surrogate for monitoring tissue temperature. Real-time analysis generates an energy difference parameter (ΔE in dB) that is proportional to tissue temperature.</p><p><strong>Methods: </strong>Post in vitro studies, two clinical studies were conducted to validate the TCM algorithm on the Sonablate® device. Studies enrolled histologically confirmed, organ confined prostate cancer patients. The first clinical study was conducted in two phases for whole gland ablation. First eight patients' data were used to measure the algorithm performance followed by 89 additional patients for long term outcome. The second clinical study enrolled five patients; four patients with focal cancer had hemi-ablation only and one had whole gland ablation. Four 3 Fr. needles containing three thermocouples each were placed transperineally in the prostate to record tissue temperatures in the focal zone, posterior to the focal zone and on the lateral gland where no HIFU was applied. Tissue temperatures from the focal zone were correlated to the ΔE parameter.</p><p><strong>Results: </strong>In the first clinical study, the average TCM rate was 86%. Pre and 6 months post HIFU, median PSA was 7.64 and 0.025 ng/ml respectively and 97% patients had negative biopsy. For the second clinical study, the measured prostate tissue temperatures (Average, Max, and Min) in the ablation zones were 84°, 114° and 60 °C and the corresponding ΔE (dB/10) parameters were 1.05, 2.6 and 0.4 resulting in 83% of temperatures in the range of 75°-100 °C and 17% in the 60°-74 °C range. Outside the focal zone, the average temperature was 50 °C and in the lateral lobe where no HIFU was applied, peak temperature was 40.7 °C.</p><p><strong>Conclusions: </strong>The TCM algorithm is able to estimate tissue changes reliably during the HIFU procedure for prostate tissue ablation in real-time and can be used as a guide for HIFU dose delivery and tissue ablation control.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2017-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35418410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volumetric magnetic resonance-guided high-intensity focused ultrasound ablation of uterine fibroids through abdominal scars: the impact of a scar patch on therapeutic efficacy and adverse effects.","authors":"Bilgin Keserci,&nbsp;Nguyen Minh Duc","doi":"10.1186/s40349-017-0100-4","DOIUrl":"https://doi.org/10.1186/s40349-017-0100-4","url":null,"abstract":"<p><strong>Background: </strong>To retrospectively compare the treatment success, therapeutic efficacy, and adverse effects of magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) treatment for uterine fibroid patients with and without abdominal scars.</p><p><strong>Methods: </strong>Seventy-six women who underwent treatment were divided into group 1 (patients with abdominal scars, which were covered with scar patches that prevents ultrasound energy from reaching the scar tissue immediately behind the patch) and group 2 (patients without abdominal scars). Non-perfused volume (NPV) ratios immediately after treatment, and fibroid volume reduction ratios and symptom severity scores (SSS) at the 6-months follow-up were assessed. All adverse effects were recorded.</p><p><strong>Results: </strong>The mean NPV ratios in groups 1 and 2 were 87.0 ± 14.1% and 91.5 ± 13.3%. At the 6-months follow-up, the fibroid volume reduction ratios in groups 1 and 2 were 0.45 ± 0.27 and 0.43 ± 0.21, and the corresponding improvement in mean transformed SSS were 0.7 ± 0.39 and 0.79 ± 0.28, respectively. No serious adverse effects were reported. The minor adverse effects encountered in this study are likely related to the temperature increase in the near-field of the ultrasound beam path, which inevitably leads to skin burns, or far-field heat absorption by distant bony structures (i.e., sciatic nerve symptoms), and are typically manifested inter-procedurally and resolved shortly thereafter.</p><p><strong>Conclusions: </strong>The findings in this study suggest that the scar patch could be used safely and efficiently in MRgHIFU treatment for the patients with uterine fibroids and abdominal scars in the ultrasound beam path.</p>","PeriodicalId":90245,"journal":{"name":"Journal of therapeutic ultrasound","volume":"5 ","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2017-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40349-017-0100-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35285019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}